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5 Myths about Physical Therapy Debunked

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Physical therapists help people of all ages and abilities reduce pain, improve or restore mobility, and stay active and fit throughout life.

But there are some common misconceptions that can often discourage those who need treatment from accessing physical therapist who specialize in the care people need.

OurHealth Richmond spoke with local physical therapists along with experts from the American Physical Therapy Association to debunk five common myths about the medical specialty.

MYTH: Physical therapy does not help back pain. Time and rest are the only solutions that help.

FACT: Physical therapy can greatly improve back pain, and too much rest can actually slow recovery.

Patients who come to physical therapy for back pain have often tried rest, and are hesitant to start therapy because of belief in this common myth. However, this way of thinking has not held up to extensive research on the treatment of low back pain. Not only that, it may make things worse for the patient in the long run. Currently, low back pain is the leading cause of activity limitation and work absence throughout much of the world. It’s estimated that up to 36 percent of people will experience an episode of low back pain in a one year period and 24 to 33 percent will experience a recurrent episode that same year. At the same time, the way low back pain is treated has changed significantly over the past several decades.

While rest from strenuous activities is a good idea, acute low back pain can be eased much quicker with gentle, active movement. A physical therapist (PT) uses therapeutic exercise and what is called neuromuscular re-education (a technique to bring back normal movement) to help the body recover and restore mobility to the spine. While it is true that excessive exercise or exercises done with poor form can strain the back, when used properly, therapeutic exercises are a powerful and natural tool for recovery and an important part of the plan of care for a patient suffering from low back pain.

In addition, a PT can help provide gentle and effective manual therapy techniques (highly specialized techniques done with the hands) to alleviate pain and allow for greater mobility. Manual therapy and therapeutic exercises are a powerful combination in improving even the most stubborn cases of low back pain.

- Samuel Waagen, PT, DPT, OCS
Bon Secours Physical Therapy

MYTH: Surgery or medication are my only options for female pelvic conditions.

FACT: Physical therapy in conjunction with other solutions can lead to better recovery.

Pelvic floor physical therapy (PFPT) can be a great first intervention or alternative to medication or surgery for many conditions including pelvic pain, incontinence, constipation, pelvic organ prolapse, and/or back pain. PFPT is a specialty practice in which a physical therapist has additional training to concentrate in abdominal and pelvic conditions.

Certain diagnoses can have musculoskeletal (bone and muscle) involvement. For example, in endometriosis, a patient may have severe pelvic pain, along with connective tissue and muscular restrictions in all of the muscles around the pelvis as a result of that pain. In most cases, if the endometrial tissue is removed via laparoscopic surgery, but the soft tissue restrictions remain, pain will not go away. PFPTs can often identify and remove soft tissue restrictions, adhesions between organs, and restore normal mobility of the abdomen and pelvis. In those cases, physical therapy along with surgery tends to be the best way to help people achieve optimal recovery.

PFPTs usually work very closely with surgeons and urogynecologists. Surgery can correct an anatomical problem, but it is important to have improved muscular control and function. Research has shown that physical therapy prior to and after surgery improves patient outcomes as well as reduces the need for future surgery.

Constipation is a good example of a common condition that most people treat with medication, however, pelvic floor muscle tightness can be a cause or effect of chronic constipation and can be addressed with pelvic floor physical therapy. Physical therapy can help retrain individuals to improve their digestion and evacuation more naturally. The same muscles can also influence your urinary control and sexual function. PFPTs work with your doctor to optimize your recovery—a balance of medication, behavioral training, nutrition, and pelvic floor retraining.

- Casey Smith, PT, DPT, CSCS
Women’s Health Physical Therapy

Myth: Physical therapy is painful.

Fact: Physical therapists seek to minimize your pain and discomfort—including chronic or long-term pain.

Physical therapists work within your pain threshold to help you heal, and restore movement and function. A survey conducted by the American Physical Therapy Association, found that although 71% of people who have never visited a physical therapist think physical therapy is painful, that number significantly decreases among patients who have seen a physical therapist in the past year.

- American Physical Therapy Association

Myth: Physical therapy is only for injuries and accidents.

Fact: Physical therapists do a lot more than just stretch or strengthen weak muscles after an injury or surgery.

Physical therapists are skilled at evaluating and diagnosing potential problems before they lead to more serious injuries or disabling conditions – from carpal tunnel syndrome and frozen shoulder, to chronic headaches and lower back pain, to name a few.

- American Physical Therapy Association

Myth: Physical therapy isn't covered by insurance.

Fact: Most insurance policies cover some form of physical therapy.

Beyond insurance coverage, physical therapy has proven to reduce costs by helping people avoid unnecessary imaging scans, surgery, or prescription drugs. Physical therapy can also lower costs by helping patients avoid falls or by addressing conditions before they become chronic.

- American Physical Therapy Association